This paper describes how intensifying competitive pressures in the health system
are simultaneously driving increased demand for safety-net care and taxing safety-net
providers ability to maintain the mission of serving all, regardless of ability to pay. Although
safety-net providers adapted to previous challenges arising from managed care, health system
pressures have been more intense and more generalized across different sectors in recent
years than in the past. Providers are adopting some of the same strategies being used
in the private sector to attract higher-paying patients and changing their image as a
safety-net provider.

This article is available a theHealth Affairs Web site by clicking
here. (Subscription required.)